Free U.S. Veterans Medical Malpractice Case Evaluation Please describe what happened* Your email address* Completing the rest of this form can help us to review your case in hours rather than days.Date of malpractice or injury Was the injured person active duty military on the date of malpractice or injury? Don't KnowYesNoIf they died, what was the date of death? At what hospital, clinic, or other location did the malpractice or injury occur? Your name Your phone number Name of person who suffered the malpractice or injury Age of person who suffered the malpractice or injury What is your relationship with the person who was injured or killed? Was the negligent person in the military? Don't KnowYesNo